The crisis in rural Alaska

Part 2 of a five-part series

Sometimes we have the experience of life breaking us… in all the right places so that we are forced to know who we really are. Many years ago, the experience of war brought me to that sacred place inside. And, if not for the healing presence of traditional people, I might yet remain trapped in a self-destructive cycle of trying to forget the past and suppressing all feeling. Along this journey I have learned, as have other war veterans and survivors of personal trauma, that denial is a disease of the soul. In the following article, I speak about hurtful truths which have affected many of us who live in Alaska. I write this not to cause pain, but with the intention of taking away the blame and the hurt. For I am convinced that only through facing the truth can we arrive at the final destination of healing and wellness. — Paul Berg

Sean was born 25 years ago to a young, single Yupik woman in a small village in the Yukon/Kuskokwim Delta. Wanting a better life for her baby, Sean’s mother gave him up for adoption to a childless couple in another part of Alaska. Sean was raised in a stable, loving home, but had periods in which he wondered who his birth parents were, who he resembled, and why his birth parents chose not to keep him. After he graduated from high school, Sean attended the University of Alaska Anchorage and became interested in researching his Native heritage with the hopes of applying for scholarship funding. With the help of his adoptive mother, Sean located his birth mother and was able to meet her and other members of her family. He discovered that his birth father had died shortly after he was born and he had a very large extended family. Sean was able to visit many of these relatives over the next couple of years.

Even though Sean now had the answers to his questions (he knew who his birth parents were, he knew he looked just like his birth father, and his birth mother has explained why he was placed in adoption), he began to feel conflicted between the culture in which he was raised and the culture of his heritage. He began to drink heavily, eventually dropped out of college, and moved back to his adoptive parents’ home. He has now been through two different treatment programs, and struggles to resist the temptations of alcohol. Sean’s story is unique in many ways. He has had the advantages of a stable, loving and prosperous family. Yet, something overwhelmed him. In this, Sean is not unique. His story is all too familiar to many Alaskans.

For thousands of years, Alaska’s Native people have hunted, fished, and prospered in one of the world’s most challenging environments. The first European explorers marveled at the resourcefulness and ingenuity of the original inhabitants of the Great Land. The image of the fur clad Eskimo is recognized world-wide as a stereotypical representative of Alaska and the people of the far north. Yet now, at the beginning of the 21st century, Alaska’s Native people, who have survived and prospered for thousands of years, are threatened by a growing crisis — alcoholism, suicide, and other physical and mental health disorders.

A 15-year-old Inupiaq girl from a small village, a student of mine last year, described part of the crisis: “There are so many suicides. … These past few years, people have either shot themselves or shot and killed someone else. Violence has gone through the North Slope like wildfire.”

According to Ron Perkins, the director of the Alaska Injury Prevention Center, rural Alaska has some of the highest suicide rates in the world. The majority occurs among young people and 80 percent are male. The Inupiaq and Yupik are particularly affected. During the summer of 2010, the number of suicides in the Kuskokwim region prompted a crisis response from Yukon-Kuskokwim Health Corporation and state officials. Health teams were dispatched to the Kuskokwim region to meet with local leaders and plan a response. Counseling and intervention services were increased and several villages organized local suicide prevention programs as a result of this mobilization.

In 2009, Gov. Sean Parnell drew public attention to another part of the crisis when he announced that Alaska is suffering through an epidemic of sexual assault and domestic abuse. In doing so, the governor committed his administration to ending what he termed “a blight” on the state. During the first decade of the 21st century, Alaska led the nation in the per capita rate of sexual crime and domestic violence. While the rate is high for the whole state, these statistics continue to spike in several large regions of rural Alaska. Specific strategies which are being implemented to end the violence include the hiring of additional Village Public Safety Officers, toughening the guidelines for prosecutors in sexual assault cases, ensuring that sex offenders are shown no leniency, and increasing funding for emergency shelters which serve victims of domestic abuse.

The state’s incarceration rate also reflects the seriousness of the crisis. In 2009, 4.1 percent of Alaska Native males 18 years and older were incarcerated in the Alaska state prison system or shipped to out-of-state facilities. Alaska Native males are imprisoned at four times the rate of the American population as a whole, resulting in Alaska having one of the highest incarceration rates in the world for indigenous people.

Other indicators of the growing crisis are found in Alaska’s health statistics.

1. The US Department of Health and Social Services reports that over 16 percent of Alaska Native adults are currently diagnosed with active diabetes.

3. The Alaska Native cancer rate is 30 percent higher than among whites.

4. In 2007, 32 percent of Alaska Native high school students had smoked within the last 30 days as compared to 13% of Alaska non-Native students. (Source: Alaska Native Health Status Report)

5. In October of 2011, the Violence Policy Center in Washington DC reported that Alaska now leads the nation in per capita gun deaths.

6. In 2011 multiple cases of tuberculosis reappeared in the Yukon/Kuskokwim Delta.

The facts support the conclusion that a major health and social crisis is spreading throughout regions of the Alaska. But facts and statistics are cold and devoid of soul. The real price of the growing crisis comes into focus when I talk with teenagers and learn about the tragedies in their families — a parent or uncle in prison, a close relative who drank himself to death, or a friend who has committed suicide.

The growing troubles have prompted extensive and well-meaning responses from the state government, the federal government, and private agencies. A program mentality has dominated these responses. One program is designed to address a particular health issue, a second program to deal with another challenge, and a third program for yet another problem. Frequently, there is little or no coordination among these efforts. Lt. Gov. Mead Treadwell, when he was chairman of the U.S. Arctic Research Commission, summarized the limitations of this fragmented approach: “Over the past two decades, the Indian Health Service and Alaska government have tried a variety of clinical and social work methods to improve Alaska Native mental health. They are simply not working.” If we step back and honestly evaluate our efforts, however well meaning, we must admit that most have fallen short.

Another aspect of the growing crisis can be illustrated by the concept of Potential Life Years (PLY’s). If the normal life expectancy is 75 years and an 82 year old grandmother dies, there is no loss of PLY’s. If a grandfather dies at age 60, there is a loss of 15 PLY’s, years he is not there to guide his children and grandchildren, to share holidays, and take part in family celebrations. In a healthy community of 500, the loss of PLY’s should be around 25 per year. The grief remains at an acceptable and manageable level. However, there a dozens of small communities in rural Alaska where the annual loss of PLY’s reaches several hundred a year. These communities are literally off the scale, drowning in grief.

All this evidence leads to me to ask several probing questions:

• Are the causes of the current situation hidden in the past?

• Are contemporary policies and practices contributing to the crisis?

• Are substance abuse, domestic violence, sexual crime, the incarceration rate, and a dozen other indicators distinct social and health disorders, or are they symptoms of a deeper malady?

• Is there a hidden disease plaguing Alaska?

These are more than mere rhetorical questions. The recent history of Native American populations in the Lower 48 demonstrates the seriousness of the situation. Case in point — the Sioux Indians on the Pine Ridge Reservation in South Dakota, which is the second largest Indian reservation in the nation. In the early 19th century, the Sioux composed one of the most successful Native American societies. Their flamboyant Great Plains culture, based on the horse and the buffalo, captured the imagination of the world. By the 20th century, all this had changed. Military conquest, isolation, and attempts to eradicate their culture had reduced the Pine Ridge Sioux to an impoverished, dependent people.

In a chillingly prophetic statement made on the Senate Floor in the early 1970’s, South Dakota Senator James Abouresk warned Congress that the Sioux of Pine Ridge were in peril. Abouresk stated that if he were consciously trying to destroy the Pine Ridge Sioux, he would set up a program similar to that being followed at the time by agencies of the United States government.

Abouresk’s brief statement proved to be sadly prophetic. Today, the Sioux of the Pine Ridge Reservation, isolated on 5,000 square miles of badlands and prairie, are the most impoverished and disease ridden people in the country. In a March 2002 article about Pine Ridge in the Wall Street Journal, staff reporter Jonthan Eig wrote, “Death haunts Pine Ridge. The community has the shortest life expectancy of anywhere in the Western Hemisphere outside of Haiti: 48 years for men, 52 for women. ”

Today, Alaska is on the edge of a precipice. We are producing a social disaster similar to that of the Pine Ridge Reservation, but on a much greater scale, over a much larger area, and involving a much larger population. The good news is that our social problems are not part of the natural order. Our deteriorating situation is not inevitable. We have a rich heritage from Native, Russian, European, Asian and a host of other cultures. We have powerful technologies at our disposal and we are one of the wealthiest societies on earth. We have the talent, we have the resources, and there is still time to turn the situation around. But the question remains — do we have the will and the determination to honestly and openly examine ourselves, our assumptions, and our practices as we seek solutions?

I realize that some who read this article will be angered and condemn me for bringing these painful realities to the forefront. But my purpose is not to extend or perpetuate a stereotype. Quite the contrary — during my 35 years as an educator throughout Alaska, I have come to a simple, yet profound realization. The indicators of the crisis, the negative statistics, and the tragic human stories are not the disease. Rather, they are the symptoms of a greater disorder, a malady which also has deep roots in the non-Native community. And one of the major symptoms of this malady is denial.

• Next week, Berg will describe historical events which contributed to the growing crisis in Alaska. Focusing on one of the last groups to have sustained contact with Western culture, Berg will share a part of Alaska history unfamiliar to many non-Native Alaskans.